Helping seniors preserve health and financial security for themselves and their loved ones.

Monday, November 18, 2013

Who Will Care for the Baby Boomers?

Most of us will need significant care support as we get old. The risk of needing long-term services and supports (LTSS) rises rapidly with age.
“Among people age 85 and older, half need some long-term care.”Who Needs Long Term Care,
Georgetown University Long-Term Care Financing Project, May 2003).

The main providers of LTSS are family of the care recipients. “Family caregiving was estimated to be
worth $450 billion in 2009, as compared to $211 billion in spending on all paid
caregiving in 2011.” Report
of the Long Term Care Commission(September 30, 2013).

The reality is that the care needs of age 80+ seniors are currently being met in large part by their family members, especially their children – who are members of the baby boomer generation.

But what will happen
a few years from now when the baby boomers transition from care providers to care recipients? Baby
boomers who are now reaching age 65 face a 70% chance that they will
need LTSS at some point during their remaining lives. Will they be able to count on the next generation to give them the care and support they will need? Probably not.

As the over 80
population increases rapidly during the next 20 years, “the number of people in
the primary caregiving years (ages 45 –64) is projected to remain flat, due in
part to changing family size and composition. As a result, the availability of
potential family caregivers (mostly adult children) to arrange, coordinate, and
provide LTSS is expected to decline dramatically and overall care burdens will
likely intensify especially as baby boomers move into late old age.” The
Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in
the Availability of Family Caregivers (AARP Public Policy Institute, 2013).

Policy analysts refer
to this demographic reality as the decline in the Caregiver Support Ratio. The Caregiver Support
Ratio is defined as the number of potential family caregivers (mostly adult
children in the 45 to 64 age group) who are available to care for those who are
over age 80.

This ratio is set to decline steeply, from 7 to 1 today (2013) to
only 4 to 1 in 2030. It is expected to fall to below 3 to 1 thereafter. Just
when the baby-boomers will be most in need of care assistance, the potential source
of that assistance will have dried up.

The recent Report of the Long Term Care Commission (September 30, 2013) acknowledges the growing
problem of a lack of caregivers (as well as the problem of the inadequate support
caregivers currently receive).

Family caregivers today provide the majority of LTSS. Those
who take on this unpaid role risk the stress, physical strain, competing
demands, and financial hardship of caregiving, and thus are vulnerable
themselves. Due to declining birthrates that will result in fewer family
caregivers than in years past, there could be greater reliance on fewer family
caregivers and the availability and quality of paid caregivers will become
increasingly important.

The Report makes a
number of recommendations to enhance the ability of family caregivers to
fulfill their role as a focus of services and supports. These include a
recommendation that the Department of Health and Human Services develop a
national strategy to support family caregivers, similar in scope to the
national strategy developed to address Alzheimer’s disease.

But none of the
Commission’s recommendations seems likely to dramatically increase the number
of human caregivers who will available to provide LTSS in 2030.

Is there any answer to
our growing caregiver deficiency?

Can Technology Help Alleviate the Caregiver Deficit?

I remember those atom
bomb “duck and cover” drills we had when I was in grade school in the 1950s. At
that time it seemed that technology was my enemy and nuclear weapons would
likely prevent me from ever reaching my “golden years.”

But the world has so
far avoided Armageddon. And I’ve now made it past 65. I no longer need to worry
about dying young, and being cheated out of my life. Instead, I’m worried about
who will take care of me as my needs increase with my advancing age.

Is the oncoming caregiver deficit destined to put overwhelming burdens on
my children and damage the quality of my life?

Or could it be that
technology will become my benefactor? Will I be able to rely on devoted electronic caregivers? Will technology provide me with the affordable
long term assistance I am most likely to need?

Current Technological Supports

There are already a
lot of technological devices to help seniors age in place. A report
by Laurie M. Orlov for Aging in Place
Technology Watch divides current tools into four categories:

Communication and
Engagement.E-mail, chat, web
surfing, Facebook, Smartphones, video games, web cameras, and texting allow seniors
to be in touch with family and other supports and stay involved in the outside world. These tools can provide
companionship and ease loneliness, which are especially important concerns for the
40% of the 85+ population who live alone.

Safety and Security.
Security systems, mobile personal emergency response systems with passive fall
detection, and sensor-based home monitors help monitor and reassure both seniors
and caregivers.

Health and Wellness.
From medication reminders, to games like the
WiiFit, to systems that remotely monitor chronic diseases like diabetes and
congestive heart failure technology is helping seniors maintain wellness.

Learning and
Contribution. Computers, including smart phones and
tablets, are allowing seniors to read, learn, take courses, and contribute
through work and volunteering. Elite Universities like MIT, Stanford and Yale
are making many of their courses available for free online. (See, 25
Colleges and Universities Ranked by Their OpenCourseWare).

But the use of
technology to care for elders is only just beginning. According to Orlov, the marketplace for
technology to assist aging adults will grow sharply from $2 billion to more
than $20 billion by 2020 including an explosion of smart phone and tablet
applications for caregiving of older adults.

The current
technologies are great aids that can help seniors maintain their independence
and quality of life. But they do not yet provide the hands-on caregiving services
that are often required. Will robots and other technological tools become
available that can help seniors with the more physical tasks of daily living?

Already service robots
(like the vacuum cleaner Roomba) are being
widely marketed. But while we are
specifically designing robots like Hector
to provide companionship and assistance to the elderly, we are not yet close to
developing a true robotic nurse’s aide. We still need people for hands-on care
like assistance with toileting, bathing, dressing and feeding.

Overall, I’m hopeful. Technology
has advanced in ways that I could never have predicted when I was in school, or
even when my children were more recently in school. There is tremendous promise for long-term
low cost support that remains patient and tireless in the face of constant demands.

So, while my kids are
not completely off the hook, I think that it is likely that robots and other technology
will be critical supports for me as I grow to need more assistance.

Given the dearth of future
human caregivers, it is clear that we need to maximize technology centered care.
I can’t wait to see what has developed by the time I (hopefully) reach my 80th
birthday.

2 comments:

I want to get my affairs in order while I am physically and mentally able to. I need to retain the services of a qualified estate planning lawyer in Olympia WA. What information do I need to get the ball rolling for a lawyer?

To locate an elder law attorney who can help you plan, call the office of a certified elder law attorney in your state. A list of certified elder law attorneys in each state is available on the website of the National Elder Law Foundation at http://www.nelf.org/find-a-cela

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About Me

I am a Pennsylvania lawyer with over 35 years experience in estate planning and elder law. I was selected by US News Best Lawyers® as its Lawyer of the Year in Elder Law for 2014 for the Harrisburg, Pennsylvania metropolitan region.
I am of counsel to Marshall, Parker and Weber, a law firm which has offices in Williamsport, Jersey Shore, Wilkes-Barre and Scranton, Pennsylvania. I am past President and a founder of PAELA (the Pennsylvania Association of Elder Law Attorneys). However, the views expressed on this site are my own and not those of PAELA or of Marshall, Parker and Weber.
Most importantly I am a husband, father and grandfather.